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I am a bit concerned about my Atripla pill. When I first started it, I had a time swallowing it because it is so damn big. My ID doc said that I could cut it in half which what I have been doing. But lately, it seems like I can only get down half the pill. Well I shouldn't say lately as in it happens everyday but it has actually happened about 3 times since I started taking it. I am worried about resistance....Suggestions? Should I call my doc on this or just wait for the next blood draw and see what that reveals?

I'm confused. When he says cut it in half he still means that you take both of the halves, you just have to do two separate swallows. Are you saying that you're only accomplishing one swallow, thus only one half?

As long as you're actually taking both halves there is no resistance issue. You need to learn to swallow... what are you going to do down the road if you need to pop 10 pills in the morning?

It's not really designed to be broken, and may result in crumbling, loss of drugs etc, a fair and real concern, the proof is in the VL test, but that may be deceptive in the short term and yes, resistance-because-of-underdosing is a reasonable worry (more the nukes than the Sustiva bit prob). But then again not, it's hard to tell if you NEED 100% of the dose to stay undetectable.

But proper prescribing wise, it's not designed to be broken.

Sustiva, the NNRTI part of Atripla, comes in small caps from 50mg up to the whole single 600mg dose in 1 tab, it may mean more actual tabs but its the same meds, they are all smaller.

Truvada, the other part of Atripla, is a relatively medium size pill and shaped to swallow.

Swallowing pills is a technique that can be learned too, and there are tricks eg spoonful of yoghurt etc.

I've not had any problems swallowing Atripla. Hell, I could probably throw three of 'em in my mouth and swallow them with no water pretty easily. I bet I'm also a fair amount bigger and therefore have bigger throat parts. Plus, some of 'us' have been dealing with big things down our throats so long that it just comes naturally!

Seriously, when I was a kid, I had to take a lot of pills for my allergies. I found that taking a drink first, holding it, popping the pill, swallowing, and then quickly chasing it with another sip seemed to work. I think my dad (a pediatrician) taught me that. It's sort of like floating the pill down. If I've had anything that could induce cottonmouth, sometimes pills are more difficult to take. I also found that a drink like sweet tea (probably a no-no for you) worked better than water. Good luck with it, as Atripla seems to work well for those of us who can handle it. It's also one co-pay, at least for me, which is certainly a good thing.

I am already resistant to one of the meds in Atripla which is why I am also taking Ziagen. Not sure if mentioned that but it is in my sig line. Yes, Philly, I can get one half down but not the other. This is like the 3rd time it has happened. I dunno about 10 pills at one time but I take 5 when I get up. They are not big thus not a problem. Uh, David, I have issues with getting other things in my mouth too... What can I say? I have a small mouth...

As Newt says, you won't get optimal benefit from chopping the pill.I have found that immersing your pill in a yummie thick substance is helpful. Have you tried pudding? milkshake? mashed potatoes,yoghurt,grits, or tossed into a bowl of cereal?Have a nice tall glass of water or(substitute substance of your choice).....Whiskey sour, grilled cheese sammie, egg salad sandwich...etc. Any favorable substance will do. The hardest part is getting past your thought process.Wishing you well sister.

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No Fear No Shame No StigmaHappiness is not getting what you want, but wanting what you have.

What I find that works very well for big pills or even handfuls is to put the pill in your mouth and tilt your head back so the pill is at the back of your throat, then take a decent sip of water and then as you lower your head down, swallow, because your throat is the most open with your head horizontal and not tilted vertically. Hope this helps.

it makes my Norvir slide right down, and keeps away the wasting syndrome at the same time. LOL

On a serious note though, try to figure out the trick that'll work. Yrs. ago I had serious mental/psychological issues about swallowing my meds because they were making me barf so much. It got so bad that just touching my meds was enough to trigger a run to the bathroom. Eventually it led to non-compliant and a really high viral load. Although I got back on track with the meds, there are still days that I'll shiver swallowing my meds; but I've usually coated them in enough food to disguise them past my tongue. Now I only puke when the meds make me puke, not because I'm freaking out on the meds.

Some mornings I just look at 'em and have a gag reflex. I swallow what I can stand before a gag then I take 10 mins break/pause--then swallowing the rest. The mental pause works for me. If there's lots of particles from halving your pills be sure to get 'em in you, as well.Hope you find your method and it all works out nicely for you.

I also agree with Matt, that there is certainly a technique, for swallowing some pills. And some can have problems getting them down without gagging. your not alone there ! Some may never be able to swallow pills correctly.

I also don't believe it a wise thing to cut that pill in half.

Some of the Fish-oil capsules I take are larger than any capsules/pills that I've ever seen. On some occasions ( but very seldom) I may have to try 2 times to get those ones down.

The way I do it..... Put the pill, almost to the back of the tongue, length wise with the tongue, and centered. Don't put it so far back, that it will make you gag, before you have a chance to swallow it.

Tilt your head slightly back,( as Joe also suggested) and have the water ready, take one fast swallow. Do this while standing. Also just like Joe suggested, do not tilt you head left or right, Look straight ahead, with your chin up slightly.

Everyone has different techniques, for doing this, you may want to practice with some larger fish oil pills, in the beginning.

I know this is all easier said than done, so it's going to take some practice. other solution, breaking that pill down to it's other components, which may make it easier to take.

I still take the Truvada/Sustiva as two seperate pills but have been planning to switch to the Atripla horse pill and will likely get my new script as Atripla after my refills run out (love torturing myself with extra co-pays). Sustiva seems big to me now can only imagine the Atripla. I have a friend who had a bad experience witha breathingh tube and ever since then he can't swallow pills - he crushes them (though he's neg and obviously wouldn't be advised for HIV meds).

The best route sounds like getting the smaller doses and take multiples instead of torturing yourself with the horse pill.

Good luck!Mike

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OK, I don't mean to hijack this, but what are fish oil pills taken for? I have read about people taking them several times on here, and I used to know what they were good for, but can't remember now.

As far as swallowing pills, Mark, I don't have any problems. I don't think I ever did. I hope you find something that works for you, Queenie. I agree that only taking 1/2 of your Atripla could probably lead to some problems.

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OK, I don't mean to hijack this, but what are fish oil pills taken for? I have read about people taking them several times on here, and I used to know what they were good for, but can't remember now.

Hi Betty,

Fish oil capsules, contain the omega 3 fatty acids ( the good fat) that may possibly help in lowering the triglycerides thus keeping a healthier cardio-vascular system : Here's a little more info. I take the 1500mg dailyof fish oil.

BobF

LOL ... I have to agree that Atripla is a "horse pill". I take alot of other pills and can take all of them at once, but Atripla has to go on it's own, with a drink standing by for that quick after swallow. I've had bigger things down my throat but they must have been more fun!

I've had the same problems with Norvir. Just to give you an idea at the orthodontist they had to use child sized bites for me as my mouth is small. I take a drink then take a mouthful of whatever I am drinking and tilt my head back then insert the pill and swallow while looking up. It still sticks in my throat a little but it always manages to go down enough that I can chug enough fluids to push it all the way down. I like the idea of coating the throat with yogurt or pudding. I may have to try that. I've been taking them with cocoa so the norvir will melt quicker in my stomach.

Thanks for all the good advice on getting it down. I was able to get both halves down last night. I was thinking of switiching to individual pills but if Sustiva is the same size as the Atripla then I would have the same problem. It doesn't happen all the time but I will be giving Nurse Leah a call. Funny, My ID doc and pharmacist said that there is not a problem cutting them in half but some of you say there is. Why is that as long as I am getting them both down.

I never had a problem getting the fish oil pills down when I was taking them. Maybe I will try to take the Atripla whole with some of the ideas that you have given me. I am just hoping that I haven't built a resistant by only taking half those 3 times which were spaced out not like 3 days in a row. I guess I will know when I get my next blood draw. Thanks Again....

I suspect that half the problem is anxiety. If you are anxious about getting the pill down, your throat automatically tightens up and makes the whole process more difficult. Before HIV meds, I had difficulty getting even the smallest pill down. Now, I have little difficulty with my Kaletra and my fish oil tablets which are enourmous.

I find this method generally works for me. Try to relax, and take a deep breath before you start. I usually start with the fish oil - the largest pill, but also a nice slippery gel cap that glides down fairly easily. Take a small sip of water to moisten your mouth and throat. Place the pill lenghtwase in the middle of your tongue, and take a medium sized sip of water. The fish oil one normally slides down, no problemo. Repeat the process with each pill. Seems to work for me.

If it does get stuck, I spit it out rather than trying to force it, walk away for ten minutes or so, calm down and try again.

I got one of those pill slicer thingies. The Atripla doesn't crumble at all. It's a nice clean cut. I get half down but still feel it in my throat so I drink some more. My technique is usually just put the pill in my mouth and add something to drink and throw my head back. Wrong technique?

throwing your head back is probably not the best idea as it restricts your throat. Try keeping your head in the normal position one takes when drinking a mouthful of liquid. the pill should pretty much slide straight back off your tongue and down your throat.

I usually put the pill in the back of my throat then throw my head back. Tonight I will try fearless's way and see how that goes. If that doesn't work then I'll go on to the yogurt. Hmm, how long does yogurt stay good for? Mine has been in the fridge for about a month. Still good?

I dont know how long it lasts cause I hate yogurt. Except the frozen kind LOLBut I do know you dont want to eat from the container and put it back in the fridge. The saliva from the spoon will start breaking down the yogurt like when you digest it. So if it is watery you dont want to eat it.

I am a bit concerned about my Atripla pill. When I first started it, I had a time swallowing it because it is so damn big. My ID doc said that I could cut it in half which what I have been doing. But lately, it seems like I can only get down half the pill.

I would pretend it's my favorite food. I would try to recall the taste, the texture and how satisfying it is. If you find you can't do it like this cold, I would eat the favorite food for 3 straight days and during those days really try to lock the taste into your memory so you can do a recall if you ever encounter the pill-swallowing problem